CCTC

Unusual Enrollment History Form

Your 2023-2024 Free Application for Federal Student Aid (FAFSA) has been flagged for “Unusual Enrollment History Review” by the U.S. Department of Education because you received Federal Pell Grant and/or Direct Loan funds at multiple institutions during the academic years reviewed: 2018-2019, 2019-2020, 2020-2021, and 2021-2022.

This flag requires CCTC to review your enrollment history and determine whether or not you are enrolling only long enough to receive cash refunds of federal student financial aid. In the process of reviewing your enrollment history, CCTC will check the National Student Loan Data System (NSLDS) to obtain a complete history including the name of the institutions you have attended and the dates of attendance.

Student Information

Student ID Number

Legal First Name

Legal Last Name

Date of Birth

myCCTC Email Address:

Phone Number

Street Address

City

State

Zip Code

Colleges or Universities Attended

Complete the question(s) below. Be sure to list all of the institutions that you attended during the following academic years: 2019-2020, 2020-2021, and 2021-2022, 2022-2023.
Please attach an academic transcript for each of the schools attended.
*For each institution attended attach a separate if you failed to earn any academic credit at that college. Attach any additional documentation (example: medical bills, hospitalization records, accident reports, etc.) that support your reason for withdrawal.

Name of College/University

Dates of Attendance

Type(s) of Aid Received (Pell/Loans)

Earned Credit?

YesNo

Did you attend another college/university?

YesNoIf "yes", please provide an additional response for each school attended.

Name of College/University

Dates of Attendance

Type(s) of Aid Received (Pell/Loans)

Earned Credit?

YesNo

Transcript Information

Have you submitted all transcripts from previous institutions to CCTC?

YesNoIf "no", please provide an additional upload for each school attended.

Upload Transcripts

By clicking the "Submit" button below, I certify that the information submitted on and with this form is accurate and complete.

Contact Information